Frequency and duration of BIS values outside 40–60 during blinded BIS recording in paediatric anaesthesia: a…

Abstract

This prospective observational study included 104 paediatric patients aged 1–19 years undergoing elective surgery under sevoflurane-based general anaesthesia and combined anaesthesia (general anaesthesia combined with a regional anaesthetic technique) between January 2022 and March 2024. BIS was recorded continuously while anaesthesiologists were blinded to the readings. Episodes of BIS < 40 or > 60 lasting ≥ 30 s were analysed. Postoperative outcomes included emergence delirium (ED) (PAED score), postoperative nausea and vomiting (PONV), and other complications in patients admitted to the PACU. Overall, 85.6% of patients experienced at least one episode outside the recommended BIS range. The median time spent outside BIS 40–60 was 22 min (35.1% of the duration of surgery). Episodes of BIS < 40 were observed in 61.5% of patients, and BIS > 60 occurred in 51.9% of patients. Blinded BIS monitoring revealed frequent and prolonged deviations from the conventionally recommended anaesthetic depth range in paediatric patients, even when anaesthesia was managed according to conventional physiological and clinical parameters. However, the clinical significance of these findings and their relationship to postoperative outcomes remain uncertain.

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BibTeX

@article{bonischova2026frequency,
  title = {{Frequency and duration of BIS values outside 40–60 during blinded BIS recording in paediatric anaesthesia: a prospective observational study}},
  author = {Tereza Bönischová and Eva Klabusayová and Adéla Kondé and Martina Klincová and Tereza Kramplová and Hana Harazim and Dominik Fabián and Veronika Kašová and Lucie Obermannová and Milka Latinovič and Jozef Klučka and Petr Štourač},
  journal = {Scientific Reports},
  year = {2026},
  month = oct,
  doi = {10.1038/s41598-026-75763-y},
  url = {https://www.nature.com/articles/s41598-026-75763-y},
  note = {CC BY 4.0},
}

RIS

TY  - JOUR
TI  - Frequency and duration of BIS values outside 40–60 during blinded BIS recording in paediatric anaesthesia: a prospective observational study
AU  - Tereza Bönischová
AU  - Eva Klabusayová
AU  - Adéla Kondé
AU  - Martina Klincová
AU  - Tereza Kramplová
AU  - Hana Harazim
AU  - Dominik Fabián
AU  - Veronika Kašová
AU  - Lucie Obermannová
AU  - Milka Latinovič
AU  - Jozef Klučka
AU  - Petr Štourač
PY  - 2026
DA  - 2026/10/17
JO  - Scientific Reports
DO  - 10.1038/s41598-026-75763-y
UR  - https://www.nature.com/articles/s41598-026-75763-y
AB  - This prospective observational study included 104 paediatric patients aged 1–19 years undergoing elective surgery under sevoflurane-based general anaesthesia and combined anaesthesia (general anaesthesia combined with a regional anaesthetic technique) between January 2022 and March 2024. BIS was recorded continuously while anaesthesiologists were blinded to the readings. Episodes of BIS < 40 or > 60 lasting ≥ 30 s were analysed. Postoperative outcomes included emergence delirium (ED) (PAED score), postoperative nausea and vomiting (PONV), and other complications in patients admitted to the PACU. Overall, 85.6% of patients experienced at least one episode outside the recommended BIS range. The median time spent outside BIS 40–60 was 22 min (35.1% of the duration of surgery). Episodes of BIS < 40 were observed in 61.5% of patients, and BIS > 60 occurred in 51.9% of patients. Blinded BIS monitoring revealed frequent and prolonged deviations from the conventionally recommended anaesthetic depth range in paediatric patients, even when anaesthesia was managed according to conventional physiological and clinical parameters. However, the clinical significance of these findings and their relationship to postoperative outcomes remain uncertain.
SN  - 2045-2322
ER  -

Abstract

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